PerspectiveA music intervention to reduce anxiety before vascular angiography procedures
Section snippets
Theoretic approach
The current study is based on Spielberger’s construct of anxiety and the assumption that state anxiety can be reduced through a music intervention (Fig. 1). Anxiety, as defined by Spielberger, is an emotional state consisting of feelings of tension, apprehension, nervousness, and worry, with activation or arousal of the autonomic nervous system. Spielberger differentiates between two related components of anxiety: state anxiety and trait anxiety. State anxiety is a transitory emotional state
Literature review
The research literature includes studies about anxiety reduction through relaxation methods, some of which included music. Three studies examined anxiety reduction in cardiac catheterization. Anderson and Masur4 used audiovisual methods of education specific for cardiac catheterization, cognitive-behavioral skills training, coping and relaxation skills training, combinations of education and training, and a neutral video as a placebo (N = 60). They found that subjects who received active
Study aims
The study aim was to evaluate whether music reduced patients’ anxiety before their vascular angiography procedures. The research question was, “Will listening to music for 15 minutes before vascular angiography reduce patients’ anxiety?”
On the basis of past research suggesting physiologic changes are impacted from music, secondary analyses were computed to test the following: Will listening to music for 15 minutes before vascular angiography decrease patients’ blood pressure, pulse rate, or
Design
This study used a quasi-experimental design with randomization to experimental and control groups. Patients were assigned using a table of random numbers to either the music or control group. The patients and staff were not blinded to assignment.
Sample and setting
The study was conducted in the Interventional Radiology Department at an urban, West coast, university-affiliated Veterans Affairs Medical Center. The institutional review board approved the study, and all participants signed informed consents.
Patients
Results
A total of 190 persons were recruited, 20 refused, and 170 persons completed the study. The control group comprised 81 persons, and the experimental or music group comprised 89 persons. The average age was 66.8 years (SD 9.95, range 37-85 years). There were 166 men and 4 women. Baseline values are included in Table I.
Ninety-eight percent of participants stated they listen to music regularly, with 48% listening at home and 25% listening in more than one location (e.g., car, work, other).
Discussion
This is the first study to test a music intervention for anxiety reduction in patients undergoing vascular angiography. This investigation contributes new knowledge to the literature with significant findings in a large sample in a newly explored setting. Anxiety reduction with a music intervention was well established in research conducted between 1994 and 2004. In a recent review of 12 studies using music interventions, 10 used the STAI to measure anxiety and 9 reported a significant decrease
Limitations
Study limitations included length of time for music intervention and participant gender. In a rapidly paced clinical environment, a 15-minute intervention was the most practical and effectively reduced anxiety in our prior study in the GI Department. Other studies report music interventions between 15 and 40 minutes with varying degrees of effect on anxiety.13 Although listening to music more than 15 minutes may have reduced anxiety further, the delay in the procedure may have provoked more
Implications for practice and research
Findings from this study add to the body of literature that music reduces anxiety and heart rate before invasive procedures. Our study supported the proposed model using Spielberger’s theory that an increased state anxiety can be decreased with self-selected music. This finding fits with the theory that state anxiety can be modified and is transient, related to the situation. The group who did not listen to music had insignificantly lower anxiety scores than the music group at baseline. Of note
Acknowledgments
We thank the nursing staff of the Interventional Radiology Department of the VA Medical Center, San Francisco, for their dedication to this study: Judy Lawing, BSN, RN; Lucinda Swendsen, RN; Linda Naugle-Cetta, BSN, RN; and Gail Clarke, RN.
References (16)
The effects of music intervention on anxiety in the patient waiting for cardiac catheterization
Intensive Crit Care Nurs
(2001)- et al.
The effect of mild to moderate mental stress on coronary hemodynamics in patients with coronary artery disease
Circulation
(1980) - et al.
Aspects of the influence of psychic stress on angina pectoris
Am J Cardiol
(1973) - et al.
Plasma catecholamine levels and cardiac rhythm before and after cardiac catheterization
Br Heart J
(1977) - et al.
Psychologic preparation for cardiac catheterization
Heart Lung
(1989) - et al.
The effectiveness of teaching a relaxation technique to patients undergoing elective cardiac catheterization
J Cardiovasc Nurs
(1992) - et al.
Music therapy in palliative care
Can Med Assoc J
(1978) The effectiveness of music as an intervention for hospital patients: a systematic review
J Adv Nurs
(2002)
Cited by (73)
A systematic review of effectiveness of interventions applicable to radiotherapy that are administered to improve patient comfort, increase patient compliance, and reduce patient distress or anxiety
2020, RadiographyCitation Excerpt :Comfort interventions were delivered before the clinical procedure in 10 studies, during the clinical procedure in 19 studies and both before and during the clinical procedure in 17 studies. Audio–visual technology interventions include audio only (n = 20),43–48,55,60,61,64,66,68,70–74,77,82,84,86 audio–visual (n = 6),50,51,53,60,69,88 virtual reality (n = 2)67,85 and visual only (n = 1).88 The interventions were used for the purpose of improving (dis)comfort, reducing anxiety, distraction, improving well-being and relaxation.
Attitudes of Preprocedural Patient Anxiety: A 2019 Cross-Sectional Study of Radiology Nurses
2020, Journal of Radiology NursingCitation Excerpt :Although less frequently, radiology nurses also supported familiarizing patients with the facility before the procedure; using traditional, complementary, or alternative medicine; or referral to a mental health provider to reduce preprocedural anxiety. The use of multimedia to reduce anxiety has been tested extensively, and relaxation audiotapes, relaxing music, and self-selected music interventions have been shown to significantly reduce patient anxiety before angiography and percutaneous biopsies (Buffum et al., 2006; Mandle et al., 1990; Soo et al., 2016). Among pediatric patients, multimedia interventions have been shown to reduce anxiety in radiologic procedures (Hart, 2013).
Music and pain during endorectal ultrasonography examination: A prospective questionnaire study and literature review
2020, RadiographyCitation Excerpt :During the last two decades studies on music and pain within radiology have involved a broad range of image modalities. They have focused on interventional radiology,23–33 CT,34–36 ultrasound-guided breast biopsy,37,38 mammography screening,39,40 and endorectal prostate ultrasound.14,16–19 In a systematic review including 42 randomized controlled trials in perioperative settings, the music interventions lasted between 5 min and 4 h with the majority between 15 and 30 min.41
Effect of music intervention on pain responses in premature infants undergoing placement procedures of peripherally inserted central venous catheter: A randomized controlled trial
2018, European Journal of Integrative Medicine
The study was funded by the Society for Vascular Nursing.